Organization Active NPI

Joseph J Fonagy Jr DPM Inc

  • Foot & Ankle Surgery Podiatrist
  • Warren, OH
National Provider Identifier
1023286671
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36003410 Issued in OH
Legal business name
JOSEPH J FONAGY JR DPM INC
Practice address
1507 E Market St
Warren, OH 44483-6611
Phone
(330) 369-1511
Fax
(330) 369-3311
NPI assigned
Feb 18, 2008
Last updated
Aug 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Christina Renee' Fonagy
Title
Office Manager
Phone
(330) 369-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36003410 OH Primary

Addresses

Primary practice location

1507 E Market St
Warren, OH 44483-6611

Mailing address

1507 E Market St
Warren, OH 44483-6611
Phone (330) 369-1511

Other identifiers 1

IdentifierTypeStateIssuer
2823181MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080305000302 OH Part B Supplier - Clinic/Group Practice 0941385645 Receives reassigned benefits from 1 practitioner
Practice locations: Warren, OH
O20100930017058 OH DME Supplier - Physician - Podiatry 0941385645 Practice locations: Warren, OH

National Provider Directory

National Provider Directory

Locations

1507 E Market St
Warren, OH 44483
Phone (330) 369-1511

1700 E Market St
Ste 114
Warren, OH 44483
Phone (330) 369-1511

1700 E Market St
Ste 14
Warren, OH 44483
Phone (330) 369-1511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1023286671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836611",
            "telephone_number": "330-369-1511",
            "fax_number": "330-369-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836611",
            "telephone_number": "330-369-1511",
            "fax_number": "330-369-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH J FONAGY JR DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "FONAGY",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "RENEE'",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-369-1511",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2823181",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.